Thank you for your question regarding the use of propranolol and its impact on your upcoming surgery. Propranolol is a beta-blocker commonly prescribed to manage conditions such as tachycardia or palpitations, and in your case, it appears to help with hormone-related symptoms due to menopause. Whether or not to stop propranolol before surgery is an important discussion to have with your surgeon and anesthesiologist. In most cases, propranolol does not need to be discontinued before surgery. Abruptly stopping a beta-blocker could lead to rebound effects, such as increased heart rate or blood pressure, which could complicate your procedure. Instead, it’s generally safer to continue the medication, but there are a few considerations to keep in mind. You should ensure that your surgical team is fully aware of your propranolol use so they can plan for any necessary adjustments during the procedure. Your anesthesiologist will monitor your heart rate and blood pressure closely during surgery because propranolol affects cardiovascular function. This monitoring ensures that you remain stable throughout the procedure. In rare cases, adjustments to your dosage may be considered, but this will depend on your individual health profile and the specifics of your surgery. Your plastic surgeon may also request preoperative tests, such as an EKG to assess your heart function and bloodwork to check for any potential issues like anemia or electrolyte imbalances. These tests are standard for patients undergoing surgery and help ensure that you’re in optimal health for the procedure. Postoperatively, continuing propranolol can often be beneficial. It helps manage stress-induced heart rate increases and promotes a smoother recovery. Additionally, propranolol’s mild calming effects may help ease postoperative pain and anxiety. Ultimately, it’s unlikely you’ll need to stop propranolol before surgery, but clear communication with your medical team is essential. Discuss your medication with both your surgeon and your prescribing doctor to ensure everyone is on the same page. Following their recommendations will help minimize any risks and ensure a safe and successful surgical outcome. Sincerely, Dr. Katzen